The Ostomy Files: A Resource for the WOCN to Support Health Literacy Post Discharge

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Amy Locke, RN, BSN, CWOCN, Professional Nurse Coordinator, ConvaTec, Inc.

  Health literacy can be defined as “the degree to which individuals have the capacity to obtain, process, and understand basic health information and services needed to make appropriate health decisions.”1 According to the Centers for Disease Control and Prevention,1 only 12% of adults have the skills needed to effectively manage their health and prevent disease.   For ostomy patients, the timing and content of education is crucial in helping improve their health literacy and adjusting to living with an ostomy. Clinicians should keep several points in mind, some of which they may or may not have been able to address during hospitalization:

•    Patients are dealing with many emotions and concerns that may include cancer diagnosis, treatments, pain, concerns about body image, and recovery from major and sometimes unexpected surgery.
•    Due to time constraints, limited resources, and short duration of stay, “…the only achievable skill during hospitalization may be learning how to empty the pouch.”2
•    Patients are discharged with literature and product samples that may be overwhelming.
•    Following discharge, patients try to establish their independence while dealing with other common concerns related to intimacy, returning to work, and social situations.
•    Stoma change and peristomal skin issues or other complications may develop.

  Throughout this process, the WOCN has a significant impact by providing self-care education and advice to patients. But where do patients go when they don’t have access to a WOCN?

  In March of 2008, a calling service was launched by the ConvaTec Customer Interaction Center (CIC), with 18 WOCNs dedicated to providing support and information to new ostomy patients. A white paper published by the Joint Commission on Accreditation of Healthcare Organizations (JCAHO)3 supports the concept of an outbound calling program, suggesting outreach calls to patients as a solution to address patient communication needs across the continuum. Self-management education to patients should be customized to the learning and language needs of the individual.

  This ConvaTec WOCN calling service works as follows:
•    A patient can sign up directly or via their WOCN or other healthcare professional.
•    At sign up, appropriate literature and product samples are sent to the patient.
•    A WOCN calls the patient several days after enrollment in the program to follow-up and reinforce nurses’ instructions in the hospital.
•    Topics discussed include appropriate product usage, information on support groups and quality of life products (ie closed end pouch), and any patient questions or concerns.

  Since it began in 2008, the ConvaTec WOCN calling service has influenced the health literacy of close to 47,000 patients.4 A patient survey completed in 2009 found satisfaction with follow-up nurse phone call after discharge was 96.29% and 93.12% were satisfied with the information and support they received (see Figure 1).5

  This WOCN calling service helps ensure that ostomy patients get the information and support they need to return to a high quality of life. For your patients to benefit from this valuable resource, call the CIC at (800) 422-8811 to speak to a ConvaTec WOCN. Together we can help impact the health literacy of those we serve.

The Ostomy Files is made possible through the support of ConvaTec, Skillman, NJ. The opinions and statements of clinicians providing The Ostomy Files are specific to the respective authors and not necessarily those of ConvaTec, OWM, or HMP Communications.

This article was not subject to the Ostomy Wound Management peer-review process.

References: 

1. Lesson 1: What is health literacy? Health Literacy for Public Health Professionals Training Program. Available at: www.cdc.gov/healthmarketing/healthliteracy/training/index.html. Accessed October 7, 2010.

2. Turnbull GB, Colwell J, Erwin-Toth P. Quality of life: pre, post, and beyond ostomy surgery. Clinician strategies for helping people with a stoma lead healthy, productive lives. Ostomy Wound Manage. 2004;50 (7A):2-12.

3. The Joint Commission.“What Did the Doctor Say?”: Improving Health Literacy to Protect Patient Safety. White Paper. Oakbrook Terrace, I: The Joint Commission;2007.

4. Locke A, Goin K, Johnson J, Oddo D. Impacting the Health Literacy of Persons Living with a New Ostomy: An Innovative and Interactive Approach. Poster presented at WOCN/WCET Joint Conference. Phoenix, AZ. June 12–16, 2010.

5. ConvaTec WOCN Calling Service Report through September 2010. Data on file, ConvaTec.